The article and protocol are for informational purposes only, and not intended as medical advice. Please read the Medical Disclaimer below, and consult with your personal physician before starting supplements and acting upon any information on this website.

Discussion

Rosacea is a common intermittent, inflammatory skin disorder, which is characterized by sensitive, red patchy areas of skin, along with clusters of capillaries (telangiectasia), which are often broken, causing increased redness of the skin. Rosacea is limited to the face, particularly the nose, cheeks, and forehead.

The trademark signs of rosacea are redness, visible capillaries, and during times of flare ups, a pus-filled bump (papule), which is often confused with acne. Flare ups can last for weeks or months.  There are many triggers that lead to flare ups (discussed below).

Though rosacea runs in families, the cause is unknown. This inflammatory disorder is currently not considered an autoimmune disorder, although among rosacea patients there is an increased incidence of autoimmune diseases.(1)

Among female rosacea patients, rheumatoid arthritis, multiple sclerosis, type 1 diabetes, and celiac disease (all autoimmune diseases) are more common than among the normal female population.  Among male rosacea patients, rheumatoid arthritis is more common than among the normal male population.

Subtypes of Rosacea

There are four different subtypes of rosacea:

• Erythematotelangiectatic rosacea (ETR) – facial redness, flushing, sensitivity or stinging in affected areas, and visible blood vessels.
• Papulopustular or “Acne Rosacea” – acne-like breakouts, broken capillaries, and very red skin.  More often affects middle-aged women.
• Rhinophyma – a rare subtype, characterized by thickened, red bumpy skin, often on the nose.  More often affects men.
• Ocular rosacea – symptoms are centered around the eyes: bloodshot, dry, burning or itchy eyes, with gritty feeling in eyes, and broken blood vessels on eyelids.

Factors That Contribute To Flare Ups

Not everyone with rosacea will be affected by the same factors, but there several identified common flare up triggers. Special note: All of these factors have oxidation as the underlying factor.

• Emotional stress
• Cigarette smoking
• Spicy foods
• Alcohol
• Hot beverages (coffee, tea)
• Hot environmental temperatures
• Sun exposure
• Menopause
• Helicobacter pylori
• A bacterium called, Bacillus oleronius, carried by the skin mite, Demodex (2)

As with all inflammatory diseases, the root cause is oxidation. This is why a lack of antioxidants is associated with more severe cases of chronic inflammatory diseases.

A lack of micronutrients, such as many vitamins, minerals, omega-3 fatty acids, and various antioxidants, are all associated with worse cases of rosacea. And the opposite is true — those with rosacea who make use of a daily regimen of a wide variety of quality supplements, particularly antioxidants, have infrequent and less severe flare ups.

Vitamins, Minerals, Omega-3 Fatty Acids, and Antioxidants

Rosacea patients have been found to have lower vitamin D blood levels than the normal population. Vitamin D is associated with the gene expression for the production of a protein, cathelicidin, which is involved in the innate immune response. (3)  With rosacea, there seems to be an over-response involving this protein, which leads to inflammation in the skin. Studies are on-going to determine how vitamin D may affect rosacea via these mechanisms.

Frustrated with failed medical treatment, many people turn to alternative and natural means to treat their rosacea. A small study was conducted among people with acne and rosacea, who incorporated dietary changes, as well as the use of vitamins, minerals, omega-3 fatty acids, and various antioxidants. (4) The micronutrients were shown to be more effective than placebo and, in some cases, more effective than commonly used medications.

Free Radical Oxidative Stress and Rosacea

Researchers have found there is higher levels of oxidative stress (free radical damage), both in the skin and systemically, in rosacea patients, suggesting that antioxidant therapy is warranted. (5) Oxidative stress is at the root of inflammation.  Oxidative stress is increased by emotional and physical stress, certain foods, medications, smoking, infections, and disease states.

Antioxidants are the antidotes to oxidative damage, as various antioxidant micronutrients neutralize oxidizing free radicals. Since rosaceous is included as an inflammatory disease, we could have guessed that increased oxidative stress would have been found, as it was. This also lets us know that a myriad of antioxidants become a useful therapeutic tool to reduce and prevent rosacea flare ups.

Topical polyphenol antioxidants have been employed with success. Among these are silymarin (or milk thistle extract) and chrysanthellum indicum extract (golden chamomile). (6)  Similarly, flavonoids and other polyphenol antioxidants, such as grape seed extract, olive fruit extract, green tea extract, and many others, are being used in creams for the treatment of rosacea.

Resolving Rosacea

I have found over the course of over two decades, that suggesting consumption of a full-range of various antioxidants, vitamins, minerals, and omega-3 fatty acids, those with rosacea have relatively quick resolutions of their flare ups. The inflammation subsides, the redness and soreness subside. The frequency and severity of future flare ups are reduced significantly.

I suggest the oral use of numerous antioxidants, such as grape seed extract, resveratrol, milk thistle extract (silymarin), green tea extract, olive extract, quercetin, curcumin (turmeric extract), lutein, zeaxanthin, etc. Many of these are combined in tablets, so that a person is not taking 20 or more tablets twice daily of just antioxidants.

In addition, a person needs a baseline of various vitamins, including vitamin D, and minerals, let alone the omega-3 fatty acids. Those with rosacea often have large pores and oily skin, which is why I suggest the use of saw palmetto (for both men and women). Saw palmetto decreases the oil production in the skin, reducing the acne affect, as well as true acne (especially in combination with grape seed extract).

Leaky Gut Syndrome and Rosacea

Small intestinal bacterial overgrowth is associated with rosacea. (7)  An imbalance of bad to good bacteria develops, leading to an overgrowth of bad bacteria in the small intestines, which in turn leads to hyper-permeability of the intestinal lining.

Another word for a hyper-permeable intestine is “leaky gut syndrome.”  With leaky gut syndrome, bacteria and other toxins seep into the bloodstream, leading to systemic inflammation, as well as an abnormal immune response in various tissues, such as the thyroid and skin. The hyper-immune response in the skin can lead to rosacea in susceptible individuals. This is why it is important to maintain good bowel flora, by taking probiotics daily.

Conclusion

The protocols work for all types of rosacea.  As mentioned, it is important to improve gut health; to improve digestion, toxic clearance by the liver, and the bowel microbiome (bacteria). What affects the gut affects the skin. To focus on treating only the skin, and not consider the importance of the bowels and microbiome, is missing the complexity of the initiation and progression of autoimmune disorders.

Of course, I also recommend the use of quality, non-toxic skin care products, which have ingredients designed to renew mitochondria and endogenous antioxidants within skin cells, as well as restore the extracellular matrix.

Protocol for Rosacea

I have included a four-tiered protocol, based upon a person’s disease severity and ability and/or desire to purchase and stay compliant to the protocols.  I suggest to at least use the average protocol below.  The minimal protocol is only for those who simply cannot afford the basic protocol. Just expect no more than minimal results by using the minimal protocol.

If you can afford it, use the advanced protocol for the quickest and most effective resolution of rosacea. The advanced protocol will obviously provide the greatest benefit in reducing the severity and progression of rosacea. Even if the skin disorder is mild, the advanced dose may still be used.

Consider using the quality skin care products associated with the quality supplement manufacturer of your preference, as this will deliver the antioxidants directly to the skin.  However, the greatest healing will occur from the oral supplements.

The article and protocol are for informational purposes only, and not intended as medical advice. Please read the Medical Disclaimer below, and consult with your personal physician before starting supplements and acting upon any information on this website. 

Minimal Protocol for Rosacea

Basic Protocol for Rosacea

Average Protocol for Rosacea

Advanced Protocol for Rosacea

• AM: With, or after breakfast
• Noon: At lunchtime with food, or shortly thereafter
• PM: Late afternoon with food, or at, or after dinner
• Please see my list of ingredients (below) that I like to see provided by a foundational vitamin and mineral supplement.
• Vision Support formula, with lutein, zeaxanthin, bilberry extract, and zinc.
• Saw Palmetto supplement, with lycopene.  (Saw palmetto can indeed be taken by women, but not during pregnancy.)
• Booster Antioxidant Supplement, with each tablet providing 50 mg Pterocarpus marsupium extract (containing pterostilbene), 10 mg Olive Fruit Extract, 75 mg alpha lipoic acid (ALA), and 60 mg Quercetin.
• Beta-glucan supplement derived from Shiitake and Reishi mushrooms and baker’s yeast extract provide numerous benefits beyond supporting brain health and immune support.
• Liver support supplement that provides numerous ingredients, including N-Acetyl-L-Cysteine (NAC), turmeric extract (curcumin), green tea extract, olive extract, broccoli extract, alpha lipoic acid, milk thistle extract, and biotin.
• Probiotics, at least take 12 billion colony-forming bacteria, providing Lactobacillus rhamnosus LGG® and Bifidobacterium BB12®, every other day or daily.
• The amino acid :L-Glutamine, 5-HTP Plus, and DHEA can be purchased from Douglas Labs by first creating a customer account by CLICKING HERE.  (If this link does not work for you, simply type “douglaslabs.com/patient-account” into a new browser tab.) Please use Referral Code 2074214. After establishing an account with them, you can then search out the product by name.

Ingredients that I like to see provided collectively by vitamin-antioxidant & chelated mineral tablets

Vitamin A, mostly as Beta Carotene
Vitamin C
Vitamin D3
Vitamin E
Vitamin K (K1 & K2)
B-Complex Vitamins
Curcumin (turmeric extract)
Quercetin
Green Tea Extract
Olive Extract
Rutin
Resveratrol
Choline
Lutein
Lycopene
N-Acetyl-L-Cysteine (NAC)
Calcium
Magnesium
Iodine (as potassium iodide)
Zinc
Selenium
Copper
Manganese
Chromium
Molybdenum
Including Ultra Trace Minerals

Medical Disclaimer

Information on this website, written, spoken, or in any other communication by Dr. Ladd McNamara or any other information or reference is for informational purposes only. The information provided on this website is a result of years of practice, experience, and study by the author. This information is not intended as a substitute for the advice provided by someone’s personal licensed physician or other healthcare professional, or any information contained on or in any product label or packaging. Do not use the information on this website, or any other form of communication from Dr. Ladd McNamara or the Dr. Ladd VIP Program, for diagnosing or treatment of a health issue or disease, or for the prescribing of medication or the use of supplementation without a discussion with your licensed health professional first.  At best, the information provided on this website is only meant to supplement information provided by your own doctor or health professional, not to replace medical advice. The information from this website is not meant to cover all possible uses, precautions, interactions or possible adverse effects of nutritional supplements with or without medications, or in conjunction with specific medical conditions. The information from this website may not fit your specific health circumstances. Never delay seeking medical care or disregard advise from your health care professional because of information you have received directly or indirectly from this website, from the Dr. Ladd VIP Program, or from Dr. Ladd McNamara himself. Always speak with your physician or other healthcare professional before making any changes to your medication or embarking on a nutritional, herbal or homeopathic supplement program, or before using any treatment for a health concern. If you have, or suspect that you have, a medical problem, contact your health care provider promptly. Do not disregard professional medical advice or delay in seeking professional advice because of something you have read or heard on this website, or due to any other information from Dr. Ladd McNamara or his representatives. Information provided on this website or the V.I.P. Program, and the use of any products or services mentioned on this website (or as a result of information provided this program, article, or website) by you DOES NOT create a doctor-patient relationship between you and Ladd McNamara, M.D.  Information and statements regarding dietary supplements have not been evaluated by the Food and Drug Administration and are not intended to diagnose, treat, cure, or prevent any disease.

References

1. Egeberg A, et al. Clustering of autoimmune diseases in patients with rosacea. J Am Acad Dermatol. 2016 Apr;74(4):667-72.e1.
2. Jarmuda S, et al. Potential role of Demodex mites and bacteria in the induction of rosacea. J Med Microbiol. 2012 Nov;61(Pt 11):1504-10.
3. Park BW, et al. A Study on Vitamin D and Cathelicidin Status in Patients with Rosacea: Serum Level and Tissue Expression. Ann Dermatol. 2018 Apr;30(2):136-142.
4. Kallis PJ, et al. A Biologically Based Approach to Acne and Rosacea. J Drugs Dermatol. 2018 Jun 1;17(6):611-617.
5. Tisma VS, et al. Oxidative stress and ferritin expression in the skin of patients with rosacea. J Am Acad Dermatol. 2009 Feb;60(2):270-6.
6. Saric S, et al. The Role of Polyphenols in Rosacea Treatment: A Systematic Review. J Altern Complement Med. 2017 Dec;23(12):920-929.
7. Drago F, et al. The association between cigarettes smoke, small intestine bacterial overgrowth and rosacea. G Ital Dermatol Venereol. 2018 Feb 26. doi: 10.23736/S0392-0488.18.05919-9. [Epub ahead of print]

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